By submitting this form, I understand that:
This Photo, Video, and Likeness Release Form grants permission to ReNU Syndrome United and its associated website(s), organizations and / or social media accounts to use photographs, video, likenesses, other media, and written content, provided by you, of you and / or your family member(s), including minors or individuals who are unable to provide consent for themselves.
Please read the form carefully and indicate your agreement by signing below.
1. Authorization and Release
I, the undersigned, do hereby grant and agree that ReNU Syndrome United and its representatives or authorized parties, has the right and permission to use photographs, video recordings, digital images, likenesses, other media, quotes, and written content that I and / or my family member(s) (including minors or individuals unable to consent for themselves, as identified below) have supplied for promotional, educational, fundraising, or informational purposes. These include, but are not limited to: usage on ReNU Syndrome United’s website, social media platforms (including Facebook, Instagram, X, etc.), and printed or other digital marketing materials.
2. Consent for Minors or Individuals Unable to Consent
If applicable, by signing this form, I confirm that I am the parent or legal guardian of the minor(s) or individual(s) named below or that I have the legal authority to provide consent on their behalf. I take full responsibility for providing this consent for the use of their photo, video, likeness, quotes, or written content.
3. Use of Names, Ages, and/or Locations
I understand and agree that ReNU Syndrome United may use a given name or a nickname for any person(s) being identified in stories or images. I acknowledge that we will reasonably undertake best practices to protect privacy where necessary or preferred while maintaining the integrity of the stories shared. Please indicate the name(s) that you prefer to be publicly visible so that we may best accommodate your preferences.
4. Rights and Use
I understand that I will not receive any compensation for the use of these images, videos, likenesses, quotes, or written content. ReNU Syndrome United has the right to use, edit, modify, and publish these materials. I waive any right to royalties or other compensation arising or related to the use of my image or recording. Additionally, I waive the right to inspect or approve the finished product wherein my likeness appears.
5. Duration and Scope of Consent
This consent is perpetual and worldwide, meaning that ReNU Syndrome United may continue to use the materials in the specified manner in perpetuity and in any geographic location. I understand that this release covers all uses unless I notify ReNU Syndrome United in writing to revoke this consent via email at ReNUsyndromeUnited@gmail.com.
6. Release of Liability
I hereby hold harmless, release, and forever discharge the ReNU Syndrome United from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.
7. Signature and Agreement
By signing this form, I confirm that I have read and fully understand the contents of this release form. I voluntarily agree to the terms and conditions and provide consent for the use of my and / or my family member(s)’ images, quotes, other media, and written content as specified.
I understand the following rights as an identified subject in the photograph:
I can withdraw the consent I have given at any time. However, I understand that there may be limits into shared and reproduced content such as that ReNU Syndrome United cannot undo what is already done.
I hereby declare that I give my full consent to this release and understand this release is legally binding to me and to ReNU Syndrome United by which I give my release to the media I provide.